Restless Legs Syndrome and Periodic Limb Movement Disorder
Restless Legs Syndrome is a movement disorder where a child reports uncomfortable
sensations in the legs when sitting still or lying in bed. To relieve these sensations the child
will move and stretch their legs, hence the term ‘restless legs’.
Many young people with restless legs syndrome also suffer with periodic limb movement disorder.
This condition causes the child to have repetitive stretching movements of the legs when falling
asleep. Generally this involves pointing the toes down (tiptoe) and moving the legs. Unlike restless
legs syndrome, the child is generally not aware of this, although this may be obvious to others in the
bed if they are sleeping alongside a parent. There is considerable overlap between these two
conditions although a child may only have symptoms in the day or in the night.
It is not known what causes restless legs syndrome or periodic limb movement disorder. Often parents of children with these conditions report similar symptoms themselves, this suggests there may be a genetic cause. It is also related to low iron levels the blood. Young people with diabetes and long term kidney disease are also known to be at risk of restless legs syndrome. The symptoms of restless legs syndrome are:
• Leg discomfort – often described as a tingling, twitching, painful feeling in the legs. This is
usually noticeable when the child has to sit still and at bedtime. Sometimes this feeling is dismissed as ‘growing pains’.
• Leg movements – children experience relief of these symptoms when they move their legs.
Adults may notice that the child has ‘fidgety’ legs.
• Difficulty settling to sleep – as the child settles to sleep the leg sensations may worsen
causing the child to toss and turn. This can make it difficult for the child to fall asleep. Older children will be able to recognise this symptom but younger children may simply appear to be difficult to settle, demanding attention, becoming fretful or resisting settling. If this results in a delayed bedtime the child may be sleep deprived and present with tiredness, reduced concentration or difficult behaviours in the day.
The symptoms of periodic limb movement disorder are less evident. Most children are not aware that this is happening to them although it can disrupt sleep and cause repeated night wakings. If this happens the child may be tired in the day, struggle to concentrate or have difficult behaviour. Managing the symptoms - Restless legs syndrome and periodic limb movement disorder can be helped in a number of ways:
Caffeine can make the symptoms worse. Caffeine can be found in lots of food and drink including tea, coffee, chocolate and fizzy drinks. These should be avoided.
Massage and cold or hot compresses to the legs in the areas where the sensations are felt (usually calves) may help they symptoms.
Checking blood iron levels: if the child’s iron levels or iron stores are low treating this with iron tablets or syrup can resolve the symptoms.
If your child has sleep disruption with obvious night wakings or daytime tiredness it will be important to test for periodic limb movement disorder. Gentle exercise in the early evening can improve night time symptoms.
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